复旦大学临床医学专业：《内科学》课程教学资源（PPT课件讲稿）内分泌系统疾病总论（高鑫）

内分泌系统疾病 总论 Introduction to Endocrinology and Metabolic diseases 复旦大学附属中山医院内分泌科高鑫

1 内分泌系统疾病 总 论 Introduction to Endocrinology and Metabolic Diseases 复旦大学附属中山医院内分泌科 高鑫

History and development of Endocrinology (1) Roughly a hundred years ago, Starling coined the term hormone to describe secretin. a substance secreted y the small intestine into the blood stream to stimulate pancreatic secretion In his Croonian Lectures, Starling considered the endo crine and nervous systems as two distinct mechanisms for coordination and control of organ function Thus, endocrinology found its first home in the discipline of mammalian physiology

2 History and development of Endocrinology (1) Roughly a hundred years ago, Starling coined the term hormone to describe secretin, a substance secreted by the small intestine into the blood stream to stimulate pancreatic secretion. In his Croonian Lectures, Starling considered the endo￾crine and nervous systems as two distinct mechanisms for coordination and control of organ function. Thus, endocrinology found its first home in the discipline of mammalian physiology

History and development of Endocrinology(2) Work over the next several decades by biochemists physiologists, and clinical investigators led to the characterization of many hormones secreted into the blood stream from discrete glands or other organs These investigators showed for the first time that diseases such as hypothyroidism and diabetes could be treated successfully by replacing specific hormones These initial triumphs formed the foundation of the clinical specialty of endocrinology

3 Work over the next several decades by biochemists, physiologists, and clinical investigators led to the characterization of many hormones secreted into the blood stream from discrete glands or other organs. These investigators showed for the first time that diseases such as hypothyroidism and diabetes could be treated successfully by replacing specific hormones. These initial triumphs formed the foundation of the clinical specialty of endocrinology. History and development of Endocrinology (2)

History and development of Endocrinology(2) Advances in cell biology, molecular biology, and genetics over the ensuing years began to help explain the mechanisms of endocrine diseases and of hormone secretion and action Although these advances have embedded endocrinology into the framework of molecular cell biology they have not changed the essential subject of endocrinology the signaling that coordinates and controls the functions of multiple organs and processes

4 Advances in cell biology, molecular biology, and genetics over the ensuing years began to help explain the mechanisms of endocrine diseases and of hormone secretion and action. Although these advances have embedded endocrinology into the framework of molecular cell biology, they have not changed the essential subject of endocrinology _____the signaling that coordinates and controls the functions of multiple organs and processes. History and development of Endocrinology (2)

ENDOCRINE GLANDS Hormone formation may occur either in localized collections of specific cells, in the endocrine glands, or in cells that have additional roles Many protein hormones: growth hormone? parathyroid hormone? prolactin? insulin? glucagon? Leptin? Formation of small hormone molecules initiates with commonly found Precursors: Such as: adrenals, gonads, or thyroid In the case of the steroid hormones, the precursor is cholesterol which is modified by various hydroxylations, methylations, and demethylation to form the glucocorticoids, androgens, and estrogens In contrast, the precursor of vitamin D, 7-dehydrocholesterol is produced in skin keratinocytes again from cholesterol by a photochemical reaction

5 Hormone formation may occur either in localized collections of specific cells, in the endocrine glands, or in cells that have additional roles. Many protein hormones: growth hormone? parathyroid hormone? prolactin? insulin? glucagon? Leptin? Formation of small hormone molecules initiates with commonly found Precursors: Such as: adrenals, gonads, or thyroid. In the case of the steroid hormones, the precursor is cholesterol, which is modified by various hydroxylations, methylations, and demethylations to form the glucocorticoids, androgens, and estrogens. In contrast, the precursor of vitamin D, 7-dehydrocholesterol, is produced in skin keratinocytes, again from cholesterol, by a photochemical reaction. ENDOCRINE GLANDS

Endocrine System 内分泌系统 内分泌腺 脏器内分泌组织 激素 体液调节系统(包括旁分泌、自分泌) 代谢过程脏器功能生长发育生殖衰老

6 内分泌系统 内分泌腺 脏器内分泌组织 激素 体液调节系统（包括旁分泌、自分泌） 代谢过程 脏器功能 生长发育 生殖衰老 Endocrine System

内分泌学发展三阶段 ●腺体内分泌学 Organic Endocrinology ●组织内分泌学 Histological endocrinology ●分子内分泌学 Moleculer endocrinology

7 内分泌学发展三阶段 腺体内分泌学 Organic Endocrinology 组织内分泌学 Histological Endocrinology 分子内分泌学 Moleculer Endocrinology

激素的种类 Hormones 肽类/蛋白类激素( Protein or peptide): ACTH, LH, FSH, PHT, TSH, Insulun, Glucagon, IGFS 氨基酸衍生物( Amino acid derivatives): 儿茶酚胺类(肾上腺素、去甲肾上腺素) 脂肪酸衍生物( Fatty acid derivatives): 前列腺素类、视黄酸 胆固醇衍生物( Cholesterol derivatives) 考的松,醛固酮、1,25(OH)2D3性激素

8 激素的种类 Hormones 肽类/蛋白类激素（Protein or peptide) : ACTH,LH, FSH, PHT, TSH, Insulun ,Glucagon, IGFs 氨基酸衍生物（Amino Acid derivatives)： 儿茶酚胺类（肾上腺素、去甲肾上腺素） 脂肪酸衍生物(Fatty acid derivatives ): 前列腺素类、视黄酸 胆固醇衍生物（Cholesterol derivatives )： 考的松， 醛固酮、1,25(OH)2 D3性激素

激素的作用机制(1) 与膜受体结合一G蛋白偶联一发挥生物效应 (肽类激素、生物胺、前列腺素) 与膜受体结合一受体自身磷酸化一发挥生物学效应 (酪氨酸激酶) (生长因子家族、 Insulin,IGFs) 与核受体结合一与DNA特异序列结合一功能蛋白转录 (甾体类激素)

9 激素的作用机制（1） 与膜受体结合 G蛋白偶联 发挥生物效应 （肽类激素、生物胺、前列腺素） 与膜受体结合 受体自身磷酸化 发挥生物学效应 （酪氨酸激酶） （生长因子家族、Insulin , IGFs) 与核受体结合 与DNA特异序列结合 功能蛋白转录 （甾体类激素）

Class Receptor Receptor-Linked G-Protein Coupled Ligand Gated Kinases Kinases Receptors lon Channels Insulin Growth Hormone Peptides Neurotransmitters Ligands Growth Factors Prolactin.Neurotransmitters, Acids Cytokines Prostaglandi General Struct dRcE豳 Protein Tyrosine or Receptor Associated 2nd Messenger lon Senine Kinase Tyrosine Kinase (cAMP, IP, lon) C ooplasmic Protein Kinases Phosphorylation Mediated Actions Non-Phosphorylation Mediated Actions

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